Musings in the life of an internist, cardiologist and cardiac electrophysiologist.

Friday, March 11, 2011

Cornered

Every day, doctors do risky things for their patients, often because they have no other options. Today is such a day for me.

I don't know how it will go, and because of privacy laws I really can't tell you about the case, I'm sorry. (Nor will you get an epilogue, that's not the point of this post). But let's just say that any normal person would consider the case I'm about to perform very high risk because of the patient's condition. Even though you tell people they could die and take care to mention that fact time and time again, you wonder if they really can comprehend the significance of what you're saying - after all, there is a fine line between being reassuring in a time of crisis and telling it like it is.

I've spoken with the family and kids at length, I've answered their questions, I've even asked that only one of them serve as a spokesperson for the entourage of family members who have come to the hospital and flown here for this day. And yes I've documented, documented, documented. I can only hope everyone knows how serious this is. Certainly the patient does.

But I also realize I assume a tremendous risk professionally doing this procedure. I've done what I feel is everything short of today's procedure in the hopes it could be avoided, to no avail. I've amassed an army of individuals to help. Monitors and medications will be assembled to counter every contingency, but there will still be the possibility that something will arise I have not considered. Most of us would rather be doing something else, but all realize there's few options than to proceed.

I know I'm not unique. This happens all the time in America in hospitals big and small: where doctors are pulled into circumstances like this as reluctant dragons, with a patients who trust in them to such an extent they'd have no one else do it but you.

Scary, really.

I hope and pray that all goes well. But as hard as this is, I wished like hell I didn't have to worry about the 800-pound gorilla who'll be in standing in the corner watching me today.

It's strange sometimes, being a doctor. People look up to us and put their faith in us, placing their own lives and those of their loved ones in our hands. In many ways, it is an honor to be so trusted, and even revered. But the reality of the situation really strikes me sometimes. Yes, we're well-studied in medicine. Yes, we're experts at what we do. Yes, we put a lot of thought into our decisions, wanting sincerely to do what's best for our patients.

But, we are also human. We have to use our own judgment. And there are often situations (presumably such as the one you're faced with) in which the right answer isn't clear--even with the vast amounts of knowledge and expertise we have at our disposal.

I work hard to do what's best for my patients. But at the end of the day, like you, I still pray that all goes well.

About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.